A longitudinal magnetic resonance imaging study of brain changes in adolescents with anorexia nervosa

Abstract

Objective: To assess whether the cerebral gray and white matter volume deficits described in patients with anorexia nervosa (AN) are fully reversible with weight rehabilitation.

Design: A prospective cohort study using magnetic resonance imaging to examine the brains of female adolescents after weight recovery from AN.

Setting: An adolescent eating disorder program located in a tertiary care children's hospital.

Participants: Of 13 patients who underwent a previous magnetic resonance imaging study at a low weight, 6 patients were weight recovered and underwent rescanning. All brain measures were corrected for the effects of intracranial volume and age, based on a regression analysis of a group of 34 healthy female control subjects. Scans from the patients with AN were also compared with scans from an age-matched subset of 16 healthy female controls.

Main outcome measures: White matter volumes, gray matter volumes, and cerebrospinal fluid volumes in the weight-recovered AN group.

Results: Quantitative analysis showed that white matter and ventricular cerebrospinal fluid volumes changed significantly (P = .03 for both) on weight recovery from AN. The weight-recovered patients had significant gray matter volume deficits (P = .01) and elevated cerebrospinal fluid volumes (P = .005) compared with those of the age-matched controls. They no longer had significant (P = .30) white matter volume deficits.

Conclusion: The finding of persistent gray matter volume deficits in patients who have recovered their weight after AN suggests an irreversible component to the structural brain changes associated with AN, in addition to a component that resolves on weight recovery.